Correlation Analysis Between RDW,RCI And The Severity Of Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To compare the clinical characteristics of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)of different severity,and to explore the predictive value of red blood cell distribution width(RDW)and red blood cell index(RCI)on the severity of AECOPD patients,in order to find more suitable and easily available serological indicators to predict the severity of AECOPD patients.Methods:By searching the Medical record management system of People’s Hospital of Jiangxi Province,Strictly follow the inclusion and exclusion criteria,157 patients with AECOPD who were hospitalized in the Department of Respiratory and Critical Care Medicine of Jiangxi Province from August 2021 to August 2022 were collected for retrospective analysis,and all Inpatients were completed with blood routine,biochemistry,coagulation,blood gas analysis,lung function and other tests and examinations,and collected the clinical data of patients,including general conditions(gender,age,height,weight,body mass index,smoking history,underlying diseases,etc.),Serological test results(blood routine,liver and kidney function,coagulation function,blood gas analysis,etc.),lung function,and then statistical analysis,analysis and comparison of various indicators between AECOPD patients of different severity,correlation analysis of the different indicators with the severity of AECOPD patients,by drawing ROC curves to evaluate the predictive value of RDW,RCI and combined detection of both of the severity of AECOPD patients,When P<0.05,the difference was statistically significant.Results:1.General comparison between the two groups:(1)There was no significant difference between patients with mild AECOPD and moderate to severe AECOPD in terms of gender,age,height,weight,body mass index(BMI),hypertension,diabetes,coronary heart disease,and smoking history(P>0.05).(2)The proportion of patients with moderate to severe AECOPD(35.6%)complicated by pulmonary heart disease was higher than that of patients with mild AECOPD(15.2%),The difference is of significance in statistics science.2.Comparison results of serological indexes between the two groups:(1)RBC and HB in the mild AECOPD group were lower than those in the moderate to severe AECOPD group,The difference was statistically significant(P<0.05).(2)The ALB of patients in the mild AECOPD group was higher than that in the moderate to severe AECOPD group and the difference was statistically significant(P<0.05).(3)There was no significant difference between patients in the mild AECOPD group and patients in the moderate to severe AECOPD group in WBC,PLT,LYM#,NEU#,EO#,NE%,PDW,CREA,UA,FIB(P>0.05).3.Contrast results of RDW,RCI between the two groups:The RDW and RCI of patients in the mild AECOPD group were lower than those in the moderate to severe AECOPD group,The difference was statistically significant(P<0.05).4.Comparison of lung function indexes measured after stable condition between the two groups:FEV1,FEV1%pred,FVC and FEV1/FVC in the mild AECOPD group were higher than those in the moderate to severe AECOPD,and the difference was statistically significant(P<0.05).5.Contrast of blood gas indexes between the two groups:PCO2 was lower in patients with mild AECOPD than in patients with moderate to severe AECOPD,while PO2 partial pressure was higher than in patients with moderate to severe AECOPD and the difference was statistically significant(P<0.05).6.The correlation analysis results of various indicators and the severity of AECOPD patients:(1)RDW,RCI,pulmonary heart disease,RBC,HB and PCO2 were positively correlated with the severity of AECOPD patients.(2)ALB,FEV1,FEV1%pred,FVC,FEV1/FVC and PO2 were inversely correlated with the severity of AECOPD patients.7.The predictive value of RDW,RCI and the combination of the two in the severity of disease in patients with AECOPD.(1)RDW had a sensitivity of 53%,specificity of 66%,AUC of 0.625 and 95%CI(0.530～0.720)at the best cut-off value of 14.05.(2)RCI has a sensitivity of 47%,specificity of 76%,AUC of 0.630,and 95%CI(0.535～0.725)at the best cut-off value of 4.32.(3)When the optimal cut-off value of the combined factor is 1.53,the sensitivity is 36%,the specificity is 91%,the AUC is 0.655,and 95%CI(0.561～0.749).Conclusion:1.RDW,RCI,proportion of complicated pulmonary heart disease,RBC,HB,PCO2,PO2,ALB,FEV1,FEV1%pred,FVC,FEV1/FVC are correlated with the severity of AECOPD patients,and can indirectly reflect the severity of AECOPD patients.2.RDW,RCI and the combination of the two tests all have certain predictive value for the severity of AECOPD patients and the predictive performance of the combined test is better than that of individual indicators.